Mark Gunderson/ShobsShowJul 20 2007 11:21fiM Global Response Corp 954-969-2388
~ MIAMIBEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REG[STRATIOIV FORM
Lobbyist means all persons employed or retained, whether paid or not, by a prindpal who seeks to encourage the passage, defeat
or modification of any ordnance, resolution, action or deciion of any commissioner; arry action, decision, recomrnendatlon of the
Gty Manager or any city board or committee; or arty actbn, decision or recommendation of any dty personnel during the time
period of tt+e entire decision-making process on such action, deasion or reoonvnendadon that foreseeably will be heard or reviewed
by the city commission, ar a clty board ar wmmittee. The term speciflrdUy includes the principal as well as any empbyee engaged
in bbbying activities. The term "Lobbyists" has spedfie e~alusbns. Please refer bo Ordinance 2004-3435.
6'df/OfitSo'~
lAt~s) ~aa M.t H
NAME OF LOBBYLSf: (last) {First) (M.I)
2510 SiP It 0~ Faetl~foi~die Pladia 33312
BUSINESS NAME AND ADDRESS (Number and Street) (City) /gG~walr,~s~~~~~.wS~rt~
9S~-Zp-1001 9~5~1-791.6LS1
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
i.0lBYIST pETAI1/ED BY:
S>1011L SIViF
NAME OF PRINCIPAUCLIENT:
p09 NW 10001 DrMe Ztitraa Flodi3a 33321
BUSINESS NAME AND ADDRESS (Number and Street) (City} (State) (3p Cade)
9s~-413~OS7 dsw~eDra~a~.~wt
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL• (Optional)
FI11 out tJNs section if prindpal is a Corporation, Partrsership orTrusl: [Section 2-482 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING, D]RECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBX ISSUE:
OppOllllidon b SJL1l LLC varLiooe - Plls *3260
Issue to be lobbied (Desalbe in detail):
iII. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Fu11 Name of Indivldual/Titie ~ B) Any Ffnandal, Fandilal or Professional Relatlonshlp
p.l
Bo~l+a o~A~olrmiea! ~i y3107) ~ NC~e
Jul 20 2007 11:21RM Global Response Corp 954-969-2388
IY. DISGL06URE OF TERMS AND AMiOUNTS Of LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURIf;
SLAT RA7F OR O'/I1ERl•
A) LOBBYIST DISCLOSURE: (Raquirod)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (RSquind). :'~~~
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-458 Entitled "Proh[bited Campaign Contributions By lobbyists
Cin Procurement Issues":
p Yes B~No• Are you IQbb~rina on a present o nendino bid for goods, eauioment or senriaes. or oa s
present or nendi~award for goods, eauioment or service?
Z) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
nYes ~o• A~syou iobbving on a pending aoolication for a Development Aereerneat with the City or
application for change of zoning map designation or chance to the Cit~r's Future Lase
Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 281 above) who only appears as a representative of snot-for-profd
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay arty registration fees..
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD.
_i
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contai din Section 2-482 of the Miami Beach City Code and all reporting
requirements. ) / ~/~,~__~
Signature of Lobbyist: / /~ U
Signature of Principal/Client: ~r_
VI. LOBBYIST IDENTIFICAT?AN: PRINCIPAL IDENTIFICATION:
^ Produced ID
Font of
C+J/Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF
State of Florida, County of Mfami-Dade
Sworn tgand subscri f me
This oC V day of , 20
.~)
Signature of Public Notary - S to of Florida
Notarization of Lobbyists signature
Amual Registration fee: [ "~ Yes [ ] No Ai
Lobtrylst Registration Form re0eived and verified b
F:\CLER1$ALL~MARIA-M~labbyist\LOBBYISr fi~RM
p.2
Y.~•~7 Produced ID _
;'•~~~~~.HO, ~ Form of Identifimtlon
~'~ .~ i
:;~® -
~~ 'D= PersonaAy known (Principal)
i 0c,
• /'''~ryo~a`•
~ZZ Z ''"'~ aro~ T. Farms
~ ~ ,z ~ to of Florida, County of Miami-Dade =~ . g= Gb3nmi~oll#DD3b0246
3. ~• -~ c om and subscribed before me =~a•~ ~ - ~ r 11 2008
,~ , ~, gu'es T'hrai
m ~ z is _~od of VL 2 _ ~''•.;~;~"~`` Ar]rmd~>Ca,Ioa
~~ ~ ~
° z a m not of Public Notary o f Florida
~° g T o 'zatlon of Prindpal's signature
rn
CL.E U LY ,/~/
' tO CR # ~~,~~~~Date Paid 7 1~ °~
ReNsed LZJ08/04